The prognostic value of serum albumin levels and respiratory rate for community-acquired pneumonia: A prospective, multi-center study

Community-acquired pneumonia (CAP) is a respiratory disease frequently requiring hospital admission, and a significant cause of death worldwide. This study aimed to investigate the prognostic value of clinical indicators. A prospective, multi-center study was conducted (January 2017–December 2018) where patient demographic and clinical data were recorded (N = 366). The 30-day mortality rate was 5.46%. Cox Regression analyses showed that serum albumin (ALB) and respiratory rate (RR) were independent prognostic variables for 30-day survival in patients with CAP. Albumin negatively correlated with the Pneumonia Severity Index (PSI) and CURB-65 scores using Pearson and Spearman tests. Survival curves showed that a RR >24 breaths/min or ALB ≤30 g/L were associated with a significantly higher risk of mortality. The area-under-the-curve (AUC) for predicting 30-day mortality in patients with CAP was 0.762, 0.763, 0.790, and 0.784 for ALB, RR, PSI, and CURB-65, respectively. The AUC for the prediction of 30-day mortality using ALB combined with PSI, CURB-65 scores, and RR was 0.822 (95% CI 0.731–0.912), 0.847 (95% CI 0.755–0.938), and 0.847 (95% CI 0.738–0.955), respectively. Albumin and RR were found to be reliable prognostic factors for CAP. This combination showed equal predictive value when compared to adding ALB assessment to PSI and CURB-65 scores, which could improve their prognostic accuracy.

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Soluble form of suppression of tumorigenicity-2 predicts clinical stability of inpatients with community-acquired pneumonia

Experimental Biology and Medicine ◽

10.1177/15353702211027116 ◽

2021 ◽

pp. 153537022110271

Author(s):

Yifeng Zeng ◽

Mingshan Xue ◽

Teng Zhang ◽

Shixue Sun ◽

Runpei Lin ◽

...

Keyword(s):

Regression Model ◽

Predictive Value ◽

Cox Regression ◽

Pneumonia Severity Index ◽

Severity Index ◽

Community Acquired Pneumonia ◽

Risk Classification ◽

Soluble Form ◽

Pneumonia Severity ◽

Clinical Stability

The soluble form of the suppression of tumorigenicity-2 (sST2) is a biomarker for risk classification and prognosis of heart failure, and its production and secretion in the alveolar epithelium are significantly correlated with the inflammation-inducing in pulmonary diseases. However, the predictive value of sST2 in pulmonary disease had not been widely studied. This study investigated the potential value in prognosis and risk classification of sST2 in patients with community-acquired pneumonia. Clinical data of ninety-three CAP inpatients were retrieved and their sST2 and other clinical indices were studied. Cox regression models were constructed to probe the sST2’s predictive value for patients’ restoring clinical stability and its additive effect on pneumonia severity index and CURB-65 scores. Patients who did not reach clinical stability within the defined time (30 days from hospitalization) have had significantly higher levels of sST2 at admission ( P < 0.05). In univariate and multivariate Cox regression analysis, a high sST2 level (≥72.8 ng/mL) was an independent reverse predictor of clinical stability ( P < 0.05). The Cox regression model combined with sST2 and CURB-65 (AUC: 0.96) provided a more accurate risk classification than CURB-65 (AUC:0.89) alone (NRI: 1.18, IDI: 0.16, P < 0.05). The Cox regression model combined with sST2 and pneumonia severity index (AUC: 0.96) also provided a more accurate risk classification than pneumonia severity index (AUC:0.93) alone (NRI: 0.06; IDI: 0.06, P < 0.05). sST2 at admission can be used as an independent early prognostic indicator for CAP patients. Moreover, it can improve the predictive power of CURB-65 and pneumonia severity index score.

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The Association between Nutritional Parameters and the Prognosis of Community Acquired Pneumonia

Asian Journal of Research in Infectious Diseases ◽

10.9734/ajrid/2021/v7i230211 ◽

2021 ◽

pp. 10-15

Author(s):

Hiba Mayya ◽

Malek Hejazie ◽

Youssef Zreik

Keyword(s):

Nutritional Status ◽

Serum Albumin ◽

Negative Correlation ◽

Pneumonia Severity Index ◽

Severity Index ◽

Community Acquired Pneumonia ◽

University Hospital ◽

Pneumonia Severity ◽

Cholesterol Levels ◽

Observational Descriptive Study

Background: Community–acquired pneumonia (CAP) is the most common potentially fatal infectious disease in adults worldwide. Prognosis depends on many factors including nutritional status. (P.S this research began before COVID19 pandemic arrivals to our country). Objective: The present study aims to assess the association between markers of nutritional status and severity of CAP. Materials and Methods: This is observational descriptive study conducted in the Department of Pulmonology in Tishreen University Hospital –Lattakia- Syria from November 2019 to November 2020. Adult patients with the diagnosis of CAP were enrolled in the study. Results: A total of 70 patients were included, Median age was 65 years, 40 (57.10%) were male. Serum albumin and cholesterol levels were lower in patients older than 65 years; (3.07±0.4 vs 3.5±0.5, p:0.001) and (135.2±33.2 vs 154.8±31.7, p: 0.01), respectively. Levels of albumin and cholesterol were significantly higher in survivors group; (3.6±0.4 vs. 2.7±0.3, p:0.001) and (158.3±23.9 vs. 120.3±35.08, p: 0.0001). Pearson's correlation analysis revealed negative correlation between pneumonia severity index (PSI) and: serum albumin (r = -0.61, p:0.0001), cholesterol(r = -0.45, p:0.0001) and BMI (r = -0.16, p: 0.1). The CRP showed negative correlation with serum albumin (r = -0.55, p:0.0001), cholesterol (r = -0.51 ,p:0.0001) and BMI (r = -0.09, p: 0.4). Conclusion: Serum albumin and cholesterol values were found to be related to the severity of CAP and initial levels may be a useful biomarkers to predict the outcome of patients.

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Prognostic value of Pneumonia Severity Index, CURB-65, CRB-65, and procalcitonin in community-acquired pneumonia in Singapore

Proceedings of Singapore Healthcare ◽

10.1177/2010105815623292 ◽

2016 ◽

Vol 25 (3) ◽

pp. 139-147 ◽

Cited By ~ 3

Author(s):

Zoe Xiaozhu Zhang ◽

Weidong Zhang ◽

Ping Liu ◽

Yong Yang ◽

Wan Cheng Tan ◽

...

Keyword(s):

Prognostic Value ◽

Pneumonia Severity Index ◽

Severity Index ◽

Community Acquired Pneumonia ◽

Pneumonia Severity

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Predicting value of neutrophil–lymphocyte ratio and CURB-65 score for early clinical stability of adult community-acquired pneumonia

European Journal of Inflammation ◽

10.1177/2058739219835106 ◽

2019 ◽

Vol 17 ◽

pp. 205873921983510

Author(s):

Xuegui Ju ◽

Shaoqiang Tao ◽

Hui Zhou ◽

Qianglin Zeng

Keyword(s):

Pneumonia Severity Index ◽

Area Under The Curve ◽

Severity Index ◽

Community Acquired Pneumonia ◽

Pneumonia Severity ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio ◽

Clinical Instability ◽

Combined Test ◽

Clinical Stability

Early clinical stability has been proven to be vital for the treatment of community-acquired pneumonia (CAP). This research retrospectively analyzed the predictive implication of neutrophil–lymphocyte ratio (NLR) and confusion, urea >7 mmol/L, respiratory rate ⩾30 breaths/min, low blood pressure, and age ⩾65 years (CURB-65) score to predict early clinical stability of the adult CAP. Clinical data, CURB-65 scores, pneumonia severity index (PSI) scores, NLR on admission (within 24 h) of 230 patients between January 2012 and June 2015 were obtained from the Affiliated Hospital of Chengdu University. Instable patients had significantly higher CURB-65, PSI, white blood cell (WBC), neutrophil, and NLR than the stable patients ( P < 0.05); NLR was positively correlated with CURB-65 (r = 0.270, P < 0.001) and PSI (r = 0.316, P < 0.001). NLR and CURB-65 were screened as risk factors through the discriminant analysis. The area under the curve (AUC) was 0.662 (95% confidence interval (CI): (0.569, 0.756), P = 0.002) for NLR, 0.670 (95% CI (0.569, 0.772) P = 0.001) for CURB-65. The enhanced predictive power was observed for combining NLR-CURB-65 with the AUC of 0.704 (95% CI (0.606, 0.802), P < 0.001). The risk of early clinical instability rose significantly in patients with NLR (odds ratio (OR) = 3.440, 95% CI (1.741, 6.798) with the cut-off value of NLR = 6.161) and higher CURB-65 (OR = 3.797, 95% CI (1.801, 8.005), with the CURB-65 cut-off value of 1.5). Both NLR and CURB-65 are qualitatively accurate for predicting early clinical stability of CAP, an accuracy-enhanced predicting power was observed in the NLR-CURB-65 combined test, further large-sample studies are required to validate the conclusion.

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Predicting mortality among older adults hospitalized for community-acquired pneumonia: An enhanced Confusion, Urea, Respiratory rate and Blood pressure score compared with Pneumonia Severity Index

Respirology ◽

10.1111/j.1440-1843.2012.02183.x ◽

2012 ◽

Vol 17 (6) ◽

pp. 969-975 ◽

Cited By ~ 9

Author(s):

JOHN ABISHEGANADEN ◽

YEW YOONG DING ◽

WAI-FUNG CHONG ◽

BEE-HOON HENG ◽

TOW KEANG LIM

Keyword(s):

Blood Pressure ◽

Older Adults ◽

Respiratory Rate ◽

Pneumonia Severity Index ◽

Severity Index ◽

Community Acquired Pneumonia ◽

Pneumonia Severity

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Evaluation of dynamic thiol/disulfide homeostasis in adult patients with community-acquired pneumonia

Hong Kong Journal of Emergency Medicine ◽

10.1177/1024907918802956 ◽

2018 ◽

Vol 26 (6) ◽

pp. 343-350 ◽

Cited By ~ 1

Author(s):

Alp Şener ◽

Gülhan Kurtoğlu Çelik ◽

Ayhan Özhasenekler ◽

Şervan Gökhan ◽

Fatih Tanrıverdi ◽

...

Keyword(s):

Blood Pressure ◽

Respiratory Rate ◽

Age Groups ◽

Pneumonia Severity Index ◽

Severity Index ◽

Community Acquired Pneumonia ◽

Mortality And Morbidity ◽

Total Thiol ◽

Diagnosis And Prognosis ◽

Significant Difference

Background: Community-acquired pneumonia is an important cause of mortality and morbidity in all age groups. Oxidant and antioxidant mechanisms play an important role in the pathogenesis and mortality of community-acquired pneumonia. Objectives: In this study, the role of thiol/disulfide homeostasis in the diagnosis and prognosis of community-acquired pneumonia was investigated. Methods: This was a prospective, controlled, observational study involving 73 community-acquired pneumonia patients and 68 healthy volunteers. Results: The native thiol and total thiol, which are thiol/disulfide homeostasis components, were significantly lower in the community-acquired pneumonia group. It was also found that the native thiol was lower in the high-risk community-acquired pneumonia group and that the native thiol and total thiol were associated with the Pneumonia Severity Index, CRB65 (confusion, respiratory rate, blood pressure, ⩾65 years old), and CURB65 (confusion, uremia, respiratory rate, blood pressure, ⩾65 years old) scores. The thiol compound levels were also associated with the C-reactive protein and procalcitonin levels. However, there was no significant difference between the survivors and non-survivors in terms of the thiol/disulfide homeostasis parameters. Conclusion: This study demonstrated the important role that oxidative stress plays in the pathogenesis of community-acquired pneumonia. The thiol/disulfide homeostasis biomarkers especially the native thiol and index-1 levels were significantly lower in patients with community-acquired pneumonia. Further studies are needed to investigate the diagnostic and prognostic value of thiol/disulfide homeostasis parameters in community-acquired pneumonia.

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